Han Jeong Hee, Lee Byoung Chul, Kim Min Ju, Choi Jung Bum, Jung Hyuk Jae, Jo Hong Jae
Department of Surgery, Pusan National University Hospital, Busan, Republic of Korea.
Department of Surgery, Biomedical Research Institute, Pusan National University, School of Medicine, Busan, Republic of Korea.
Medicine (Baltimore). 2024 Dec 13;103(50):e40696. doi: 10.1097/MD.0000000000040696.
The number of older adult patients with colorectal cancer (CRC) is steadily increasing with the increasing aging population. However, healthcare professionals continue to approach treatment in older adult patients while considering the potential coexistence of complications relative to their age. There is a tendency to define and limit treatment options for managing "older adult patients" at relatively younger ages. Given the progression of aging societies and aging of patients with CRC, the impact of age on post-surgical outcomes should be analyzed to guide treatment decisions and ensure the highest quality of care for this population. This study aimed to compare outcomes in patients aged approximately 80 years who have undergone surgery after being diagnosed with CRC at the National Pusan University Hospital. This retrospective observational study included 502 patients who underwent surgery after being diagnosed with CRC at Pusan National University Hospital from January 2018 to December 2022. All surgeries were performed by a single surgeon. Older adult patients underwent open surgery more frequently. No significant differences in surgical outcomes or hospital stay were found between the two groups. Moreover, no notable differences were observed in overall complications, including major surgery-related complications such as anastomotic leakage, bleeding, and infection, between the two groups. However, pneumonia was significantly more common in the older patient group (P = .016). Among patients requiring emergency surgery, the older adult group demonstrated a significantly higher proportion of emergency surgeries and complications associated with regular surgeries compared with the younger group. In older adult patients, the risk of postoperative complications should not be determined solely based on age; a comprehensive assessment is necessary. However, in the case of emergency surgery, older adult patients may be relatively vulnerable compared with younger patients.
随着人口老龄化加剧,老年结直肠癌(CRC)患者数量在稳步增加。然而,医疗保健专业人员在治疗老年患者时,仍会考虑到与他们年龄相关的潜在并发症共存情况。存在一种倾向,即在相对年轻的年龄段就定义并限制针对“老年患者”的治疗选择。鉴于老龄化社会的发展以及CRC患者的老龄化,应分析年龄对手术后结果的影响,以指导治疗决策,并确保为这一人群提供最高质量的护理。本研究旨在比较在釜山国立大学医院被诊断为CRC后接受手术的约80岁患者的治疗结果。这项回顾性观察研究纳入了2018年1月至2022年12月期间在釜山国立大学医院被诊断为CRC后接受手术的502例患者。所有手术均由一名外科医生进行。老年患者更频繁地接受开放手术。两组在手术结果或住院时间方面未发现显著差异。此外,两组在总体并发症方面,包括与手术相关的主要并发症如吻合口漏、出血和感染,也未观察到明显差异。然而,老年患者组肺炎更为常见(P = 0.016)。在需要急诊手术的患者中,与年轻组相比,老年组急诊手术的比例以及与常规手术相关的并发症显著更高。对于老年患者,术后并发症风险不应仅基于年龄来确定;需要进行全面评估。然而,在急诊手术的情况下,老年患者可能比年轻患者相对更脆弱。